Cover Oregon assister Donna Medica ready to answer questions

Donna Medica sat alone for well over two hours in the North Plains Library last Friday, equipped with her computer, a large notebook of paperwork and a head filled with information about Cover Oregon, Oregon’s version of the Affordable Care Act (aka Obamacare).

The only thing missing was the people.

Medica has been specially trained to help people navigate the Cover Oregon website and answer questions about the new health system. She will be offering presentations and question-answer sessions all month.

But so far, Medica hasn’t had a lot of takers. “I think people aren’t really thinking about it,” she said.  

The North Plains librarian applied to be a Community Partner Enrollment Assister because, she said, she really cares about people and believes everyone should be insured.

In addition, Medica will dedicate 30 hours a week for the next six months to educating the public about the changing health care system, including available plans, cost comparisons and financial aid. That work is funded by an Oregon Health Authority grant that the North Plains Library applied for and received.

The number of folks attending question-and-answer sessions has been low, thanks at least in part to the fact that the Cover Oregon website is not ready to take online applications. Medica estimates the application part should be ready in about two months.

But the rest of the site still holds useful information, such as policy descriptions, a list of participating insurance companies and calculators of tax credits or other applicable assistance. 

It can also provide personal guidance. A help section links the public to assisters such as Medica and to insurance agents. 

“Assisters can’t give advice,” Medica pointed out, “but agents can.” 

The law requires agents to provide free help--a godsend for complicated situations.

If you need to see only one specialist, for example, the website can direct you to the right plan. But if you need to see several specialists, an agent can better navigate the situation.

The state of Oregon has used another tactic to cull the number of potential applicants. About 260,000 people--food-stamp recipients and parents whose children are part of the Healthy Kids program--recently received fast-track notification letters approving them for Medicaid and offering a choice of two plans. Enrollment is automatic if people return the letter with choices marked. 

“That's 260,000 people not clogging up the (Cover Oregon) website,” Medica said.

People who didn’t receive a letter but think they might be eligible can call I-800-699-9075.

Most Oregon insurers are available through Cover Oregon, Medica said. But insurers and their offerings are specific to certain regions, so someone who moves from Portland to Ashland would need to reapply.

Only a person's geographic location and smoking status are considered when calculating insurance rates during the Cover Oregon application process. Medica said the site does ask for some personal information, such as prescription use, outstanding medical bills or frequency of doctor visits, but those questions are not mandatory.

Small-business owners can use the Cover Oregon site as well. Businesses with fewer than 25 employees will receive tax credits if they provide coverage. The employer can choose the plan and coverage level (70/30, for instance) or they can leave the choices up to the worker. Employees go to the site to apply, and the employer is billed once per month for all covered participants. Businesses must use an insurance agent for advice, not assisters such as Medica.

Oregon’s system mirrors the current system for Medicare. The window for sign-ups is from October to December of each year. During this open enrollment period, changes may be made to coverage levels and insurers. The new coverage will then take effect Jan. 1 of the following year. 

In 2014, the first year of implementation, the open enrollment period goes through March 31, but anyone applying by Dec. 15, 2013, will be covered Jan. 1.

Paper applications are available both through enrollment assisters and on the website, with a turnaround of about 45 days. 

Who needs to use the website or find an enrollment assister? People who are uninsured,underinsured, or whose current insurance is too expensive.

Those whose incomes are between 138 and 250 percent above the poverty line will get tax credits and other assistance. To receive this extra help, however, the recipient must choose a Silver plan. (Plans are rated Bronze through Platinum.)

Technology alert: The website works best with the Google Chrome browser, but the paper application — which, despite the name, can be filled out online — works best with Microsoft Internet Explorer.

Those who wish to opt out of the Affordable Care Act do have choices. There are exemptions for certain classes of people, such as Native Americans. Persons who have had a green card for more than five years can be covered.

Medica is available to speak at churches, community groups and businesses. She can be reached at the North Plains Library, 503-657-5051.

Presentation and Q&A dates set

The North Plains Public Library — specifically, librarian Donna Medica — is offering free workshops and question and answer sessions for those interested in learning more about Cover Oregon, the state’s health insurance marketplace mandated by the Affordable Care Act.

Presentations will be held around Washington County and are scheduled as follows:

n Wednesday, Nov. 6 from 7 to 8:30 p.m. at the Jessie Mays Community Hall, 30975 N.W. Hillcrest St. in North Plains.

n Thursday, Nov. 7 from 11 a.m. to 1 p.m. at the North Plains Public Library, 31334 N.W. Commercial St.

n Monday, Nov. 11 from 7 to 8:30 p.m. at the Jessie Mays Community Hall.

n Tuesday, Nov. 12 from 11 a.m. to 2 p.m. at the North Plains Library.

n Wednesday, Nov. 20 from 7 to 9 p.m. at the Forest Hills Golf Course, 36260 S.W. Tongue Road in Cornelius.

n Saturday, Nov. 23 from 1 to 2:30 p.m. at the Jessie Mays Community Hall.

n Tuesday, Nov. 26, evening presentation at the Forest Grove Library, 2114 Pacific Ave. Time to be announced.

n Thursday, Dec. 5 from 7 to 8:30 p.m. at Cornelius City Hall, 1355 N. Barlow St. in Cornelius.

n Saturday, Dec. 7 at the Cedar Mill Library, 12505 N.W. Cornell Road. Time to be determined.

n Tuesday, Dec. 10 at the Beaverton City Library, 12375 S.W. Fifth St. in Beaverton. Time to be determined.

n Saturday, Dec. 28, question and answer session at the Forest Grove Library, 2114 Pacific Ave. Time to be announced.

To arrange a free presentation or receive printed materials to distribute, contact Medica at 503-459-8325, 503-647-5051 or This email address is being protected from spambots. You need JavaScript enabled to view it..

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